Chronic appendicitis

Chronic appendicitis usually develops as a result acute. This term is sometimes used to refer to "cold season" with recurrent appendicitis regardless of the presence or absence of complaints and objective disorders. But correct to speak about chronic appendicitis in cases, when after the acute attack normal health is fully restored. Pain, often with diarrhoea phenomenon, constipation, systematically disturb the patient, stubbornly kept some soreness in the area of process - in points to Mac Bernie, Lanza, Nummela. In some cases the pain of a permanent nature, insignificant, but increased during exercise, the errors in the diet, others appear only intermittently, in the form of a rather intense, but short "colic". The latter is sometimes accompanied and a separate objective symptoms characteristic of acute appendicitis, but not sharp and fast disappearing. The term "sub-acute appendicitis, which had identified such conditions, it should not be used: it allows to justify the wrong conservative tactics of the surgeon, and any such "exacerbation of chronic appendicitis can in the next few hours to give phenomena acute attack with all its consequences.
In some patients repeated complaints and disorders appear gradually, without prior distinct attack of acute appendicitis. Then talk about primary chronic appendicitis, though not all surgeons recognize this nosological form, considering that in some cases the complaints caused by any other illness, in others the process changed again in connection with the gallbladder disease, duodenal ulcer, etc., a Number of observations shows that such a link does exist. It is important that patients with suspected chronic appendicitis at any moment it is possible a development of the classical picture of jail appendicitis.
The diagnosis of chronic A. not difficult, if history is reliably established and documented (especially personally observed this surgeon) an attack of acute A. If negative or questionable historical data of recognition chronic A. - a very difficult task, as the clinical symptomatology (except for the periods of exacerbation) scarce and uncertain. Therefore, the basis of the diagnosis of chronic A. in such cases, is a careful study of all other bodies. When Troubleshooting by excluding attention should be first of all directed on the right kidney and ureter. In many patients with the right kidney stone to the date of discovery of the calculus already have a scar from appendectomy, not removing pain.